TC Intake Form
This is where the MAGIC happens! Leave us the deets and we'll get it to closing!
Agent
*
First Name
Last Name
Co-Agent
First Name
Last Name
Office Location
*
Center Valley
Berks County
Address & Client Info
Contract Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Client Type
*
Buyer
Seller
Dual (Did you get broker approval?)
Client 1
*
First Name
Middle Name
Last Name
Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
E-mail
*
example@example.com
Client 2
First Name
Middle Name
Last Name
Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
E-mail
*
example@example.com
Contract Details
Contract Date
*
-
Month
-
Day
Year
Date
Purchase Amount
*
Commission % or Flat Fee - Enter Below Please
*
TC Amt Collected
*
Broker Fee Amt Collected
*
Escrow Held By
*
Listing Agent / Broker
Buyer Agent / Broker
Title Company
Attorney
Seller - New Construction
Other
Title Company
*
Power Settlement Services
Other
If other, please specify:
Lender
*
Leonard Tabone, Revolution Mortgage
Tim Melcher, Fidelis Mortgage
Denis Trelease, Univest Bank
Other
If other, please specify:
Property Questions
You're almost done...I promise!!! ;)
Inspections
*
Home
Wood
Radon
Septic
Well
Other
N/A
HOA
*
Yes
No
Appraisal
*
Yes
No
Home Warranty
*
Yes
No
Built Before 1978
*
Yes
No
NextHome Conceirge
*
Yes
No
Any additional information we may need to know? Don't hold back....
Upload the fully executed ASR. Thanks!
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